PhD‐DNP Collaboration: An Integrative Review of Scholarly Partnerships in Nursing

ABSTRACT

Nurses holding terminal degrees, Doctor of Philosophy (PhD), Doctor of Nursing Science (DNS), and Doctor of Nursing Practice (DNP), fulfill different roles in nursing. The continued growth of nursing science and practice is dependent on alliances between these nurses that produce state‐of‐the‐art knowledge and support the translation of evidence to practice. This integrative review described characteristics of scholarly collaborations between nurses holding a research‐focused degree, the PhD, and those holding a practice‐focused degree, the DNP. Five major nursing, medicine, and education databases were searched for peer‐reviewed, original articles addressing or describing the characteristics of PhD‐DNP scholarly collaborations, published through March 2023. In total, 15 articles met the inclusion criteria, and an integrative synthesis was conducted using constant comparison and thematic analysis. Findings included one overarching theme, Role Clarification, as well as four subthemes that emerged across the sample, describing key characteristics of collaborative PhD‐DNP scholarship: (1) Mutual understanding and appreciation of strengths; (2) Strategic project planning and team building; (3) Clear organizational/administrative directives and guidance; and (4) Shared goals for the nursing profession. Articles describing the collaboration between nurses holding doctoral degrees are limited and provide primarily lower‐level research evidence and evidence‐based practice outcomes. Despite efforts to foster scholarly collaborations among nurses holding terminal degrees, more research is needed to clarify individual roles, offer tangible strategies for collaboration, and measure outcomes of collaboration benefitting healthcare systems, patient outcomes, and the nursing profession. This integrative review involved only the review of the extant literature.

1. Introduction

The American Association of Colleges of Nursing (AACN) defined nursing scholarship as the generation and translation of knowledge to transform health care (American Association of Colleges of Nursing ²⁰¹⁸). The terminal degrees in nursing were designed to perpetuate the generation and translation of nursing research evidence to continuously improve health care. Terminal doctoral degrees within the nursing profession include the Doctor of Philosophy (PhD) and the Doctor of Nursing Science (DNS), with a focus on nursing research and science, and the Doctor of Nursing Practice (DNP), with a focus on nursing practice and healthcare system administration. While PhD‐prepared nurses conduct research studies to generate new generalizable knowledge to advance and expand nursing science, DNP‐prepared nurses translate research evidence into nursing practice through evidence‐based practice (EBP), quality improvement (QI), and other projects in clinical settings, to improve healthcare delivery and patient outcomes. The strengths and foci of the PhD and DNP degrees amplify the need for nursing professionals to develop nursing scholarship in unison or collaboratively. Because scholarship is the process by which a discipline develops knowledge (American Association of Colleges of Nursing ²⁰¹⁵), the way in which nursing leaders approach scholarship is critical to the growth of the nursing profession and science. Through collaborative partnerships, academic and practice nurse leaders can accelerate the generation and dissemination of new knowledge, scientific inquiry, evidence‐based QI, and evidence‐based health policies that affect health and health outcomes (Trautman et al. 2018).

1.1. Background

The landscape of nursing science generation and translation has drastically changed over the last two decades, due to the change in educational pathways to the terminal degree in nursing. Originally, the path to a doctoral degree in nursing was only through a research‐focused degree, the PhD, whose key goal was to develop the science that informed practice. In 2004, a practice‐focused doctoral degree, the DNP, was implemented in the United States. From 2005 to 2024, the American Association of Colleges of Nursing (2024) reported DNP programs growing from only 13 in 2005 to 433 DNP programs at schools of nursing nationwide, demonstrating immense and consistent growth. Unfortunately, this rapid growth has been overshadowed by concerns of inconsistencies in the preparation of DNP nurses across academic programs in the United States (American Association of Colleges of Nursing ²⁰¹⁵) and lingering confusion among nurses and employers regarding the role of the DNP in practice (Udlis and Mancuso 2015). As DNP programs increased, from 2012 to 2021, PhD degree trends demonstrated a decline in enrollments and graduations, with an enrollment peak of 5290 in 2014 to 4476 in 2021 (American Association of Colleges of Nursing ^2022b). The unease and confusion regarding the DNP degree, coupled with the decline in PhD student enrollment, is concerning because the scholarship produced by these nurses is the backbone of knowledge generation, application, and integration to continuously improve health care in the United States.

Understanding and collaboration between terminally‐degreed nurses may be critical to the delivery of quality health care. In the United States and internationally, there have been fears that a shortage of PhD‐prepared nurses would impede the development of evidence to inform practice, as the PhD nurse is primarily viewed as the scientist generating new knowledge (World Health Organization ²⁰²⁰). The PhD nurse, however, is also seen as the steward of the nursing discipline, not only developing new knowledge but also conserving previous work and widely disseminating evidence (Broome et al. 2023). The confusion of stakeholders regarding the value and purpose of the DNP threatens a major goal of the DNP, to translate and apply research evidence into practice within the healthcare system. Threats to the development, conservation, and application of nursing research into nursing practice could have serious repercussions on the quality of health care and patient outcomes in the United States. DNP nurses apply evidence generated most often by PhD scholarship. PhD nurses use the clinical insight of QI and EBP findings from DNP scholarship to determine gaps in practice where further research is needed. Each degree feeds the other through its scholarly endeavors. Understanding how nursing professionals with PhD and DNP terminal degrees best collaborate in their scholarly endeavors is critical to the continued growth of nursing science and EBP.

To study scholarly collaborations between PhDs and DNPs, we must also understand their roles and collaboration in the clinical setting and how they vary globally. Regardless of country, most doctorally prepared nurses work in academic settings focusing on research and education (Orton et al. 2019). This phenomenon is due to doctorally prepared nurses' poorly defined role within the clinical setting, often misunderstood by administrators and nurse managers (Beeber et al. 2019; Orton et al. ²⁰¹⁹). Dobrowolska et al. (2021) conducted a scoping review to clarify the roles of doctorally prepared nurses in the clinical setting. Outcomes of their review, including studies primarily from the United States and Nordic countries, indicated pervasive role confusion and unclear clinical career prospects among both PhD and DNP nurses and their employers. Beeber et al. (2019) conducted an online survey and qualitative interviews with DNP program directors and DNP employers in the United States and found that employers lacked knowledge of the capabilities of doctorally prepared nurses.

Orton et al. (2019) conducted qualitative interviews with PhDs working in clinical settings, also finding that employer expectations of this role needed to be clarified to emphasize the potential contribution a researcher in a clinical setting can bring to EBP and practice improvement. Both DNP‐ and PhD‐prepared nurses experience difficulties contributing their expertise in the clinical setting due to a lack of official role descriptions, work standards, and job skills consistent with their educational preparation (Beeber et al. 2019; Minnick, Kleinpell, and Allison ²⁰¹⁹). The lack of consistent role descriptions by universities and employers in clinical settings hinders the degree to which DNP‐ and PhD‐prepared nurses can collaborate and contribute in the clinical setting and in the academic setting to improve quality of care.

The impact doctorally prepared nurses can make from a global perspective, given their scientific knowledge base, is critical to the growth of nursing science (Andreassen and Christensen 2018). The common difficulties faced by nurse professionals in the United States and globally support the need to understand their scholarly collaborative efforts and the factors that influence those efforts in academic and clinical settings. Clarifying the status of these collaborative efforts will provide a more complete description of the problem and a basis to propose evidence‐based solutions. Considering the limited existing literature on this topic, an integrative review, including quantitative and qualitative studies, as well as case studies, theoretical work, expert reviews, and evidence‐based QI work, was conducted to synthesize the evidence and describe the scholarly collaboration and partnership between PhD and DNP prepared nurses in varied settings.

1.2. Purpose and Research Question

Through this integrative review, we sought evidence of key factors associated with collaborations and partnerships between nurses with differing doctoral degrees to advance nursing science and practice and improve healthcare outcomes. Our research question framed by population, concept, and context (Peters et al. 2021) was: Among nurses who hold the terminal degrees of PhD and/or DNP, how is collaboration defined and how can scholarly partnerships in research, quality improvement (QI), or other evidence‐based practice (EBP) projects best be supported? Findings from this study describe the characteristics of contemporary PhD‐DNP scholarly, collaborative endeavors and provide a framework to increase scholarly efforts supporting the continued growth of nursing science and implementation of innovative EBP.

2. Methods

2.1. Search Strategy

We conducted a systematic search of the following databases: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Elton B. Stevens Company (EBSCO), Education Resources Information Center (ERIC), and MEDLINE. Our search string was “PhD AND (DNP or doctoral prepared nurs*) AND collabor*.” We conducted the search in March 2023. A health science librarian from a major research institution in the Southeast United States supported the search process. We used the web‐based Covidence systematic review tool (Covidence n.d.) to organize and record the process of screening and data extraction (Kellermeyer, Harnke, and Knight ²⁰¹⁸).

2.1.1. Inclusion and Exclusion Criteria

We included studies and reports that (1) focused on PhD and DNP scholarly collaboration or partnerships; (2) were published in peer‐reviewed journals; (3) were in English; (4) had full texts available; and (5) were published before March 2023. We excluded articles that primarily focused on PhD, DNP, and dual degree PhD/DNP scholarship without collaboration. Additionally, we excluded gray literature (news, editorials, advertisements from schools, supplementary information, patents, abstracts, and unpublished reports). When multiple papers with similar conclusions were published by the same authors, only the most recent publication was included in this review. Lastly, we conducted a secondary review of references within the included articles, or an ancestry search, to increase the effectiveness of the search.

2.1.2. Selection Process

All the articles identified from the database searches were initially screened via title and abstract by two authors (J.B. and R.S.K.) and subsequently double‐checked by both authors. We retrieved full texts and independently reviewed them to determine study eligibility. We discussed ambiguous papers that were reviewed by another author (N.S.), and full agreement was required to proceed with extraction.

2.2. Evidence Quality

Three authors (R.S.K., J.B., and T.J.G.) assessed the evidence quality of eligible studies using the Johns Hopkins Evidence‐based Practice Appraisal Tool (Dang et al. 2022). Each study was classified as Level I to Level V based on design and level of evidence. The quality rating included high quality (A), good quality (B), and low quality or major flaws (C), based on the generalizability of results and overall scientific method of the work. See Table 1 for quality appraisal.

Table 1.

Quality appraisal table using Johns Hopkins Evidence‐Based Practice Appraisal Tool.

References	Design/theory	Level	Quality	Comments
Cowan, Hartjes, and Munro (2019)	Expert Review with Exemplar	V	B	Strong review of the literature; clear aims; exemplar strengthened conclusions; clear recommendations.
Cygan and Reed (2019)	Qualitative Descriptive	III	B	Described qualitative studies conducted by DNP and PhD collaborators; clear objectives, reasonable recommendations.
Edwards et al. (2016)	Educational/Curricular Initiative	V	A	Clear objectives; described the development and implementation of successful DNP and PhD program collaboration, clear recommendations.
Graves et al. (2021)	Targeted Review of the Literature	V	A	Clearly identified (1) the role of the DNP, (2) examples of PhD‐DNP collaborations, (3) training models that support collaborations, and (4) the outcomes of intraprofessional collaborations.
Jenkins et al. (2020)	Educational Initiative and Qualitative Methods	V	B	Educational initiative using mixed methods; aims clear; scientific methods described, conclusions supported by findings.
Kennedy, Cameron, and Munyan (2022)	Case Analysis of Research and Practice Exemplar	V	A	Used Tuckman's five‐stage model for high‐performance team development. Contributes to clinical relevance.
Mauro et al. (2018)	Descriptive Observational	III	A/B	Descriptive survey design. Evaluated simulation‐based strategies using an unfolding chronically ill adult case to address population health.
Merrill et al. (2013)	Descriptive Observational	III	A/B	Contributes to the research questions through a nonlinear quantitative approach to doctoral education initiatives.
Nickasch et al. (2018)	Mixed Methods	III	A/B	A mixed‐methods approach employed to gather data, incorporating both quantitative and qualitative methodologies; Identified barriers and problems of the collaboration between PhD and DNP.
Pinto, Dail, and Andrews (2021)	Educational Initiative	V	A	Program evaluation/action research methodologies, focused on evaluating the outcomes of specific strategies implemented to foster research collaboration and scholarship productivity among PhD and DNP.
Rocafort (2020)	Grounded Theory	III	A/B	A single qualitative study; Strauss and Corbin's grounded theory method was employed. The nursing profession is progressing towards self‐identification, with a recognized need and acceptance for doctoral roles underscoring advancements in practice and greater cohesion within the discipline.
Staffileno, Murphy, and Carlson (2017)	Qualitative Descriptive	III	A/B	Used focus group and content analysis; provides valuable qualitative insights into the factors affecting collaboration among nursing faculty.
Travers, Weis, and Merrill (2018)	Descriptive Observational	III	A/B	An observational study without randomization; results showed improved student connections and the methodical analysis used offered solid evidence that such an organization can enhance collaboration among nursing students.
Vermeesch et al. (2018)	Descriptive Observational	III	A/B	Highlights the value of integrating diverse academic perspectives to enhance practical skills and ethical understanding in nurse practitioners, emphasizing the importance of such interdisciplinary efforts in advancing nursing education and practice quality.
Vincent et al. (2010)	Theoretical Analysis	V	B	A conceptual model was employed to distinguish between PhD and DNP roles, specifically identifying the DNP's responsibility in translating PhD research findings into practical applications.

2.3. Data Extraction Process

Three authors (R.S.K., T.J.G., and L.S.) extracted the data from the studies and reviewed the data extracted, and two authors (R.S.K. and T.J.G.) confirmed the accuracy of data extraction. We developed an evidence table to extract data from eligible studies, which included authors, publication year, purpose, design, setting, sample, methods, findings; and recommendations and related interpretations regarding PhD and DNP scholarly collaborations in the field of nursing education, research, leadership, or clinical practice.

2.4. Risk of Bias Assessment

The authors assessed the risk of bias using the quality assessment template within the data management tool software. Extraction of risk of bias data was conducted through the data management tool, Covidence, allowing three authors (J.B., R.S.K., N.S.) to collaborate in real‐time. Constant checking and review ensured consistency and integrity of the quality assessment, thus ensuring the credibility and dependability of the evidence (Lockwood, Dos Santos, and Pap ²⁰¹⁹). We determined the articles to be small studies or evidence‐based projects at the pilot study stage with low bias and negligible missingness. No effect sizes were reported.

2.5. Data Synthesis and Analysis

To answer our research question, we focused on identifying common concepts and characteristics highlighted in our identified studies as pivotal to the scholarly collaborations described among doctoral degree nurses. Due to the inclusion of research studies, EBP and QI projects, educational initiatives, case studies, reviews, and theory papers, we adopted Whittemore and Knafl's (2005) integrated review data analysis techniques. Specifically, we used the four phases of constant comparison: data reduction, data display, and data comparison, as well as thematic analysis to analyze and synthesize findings across studies. We deconstructed the data in multiple ways, which enabled us to identify and categorize the characteristics key to collaborations between PhD‐ and DNP‐prepared nurses. This process led us to clearly identify common themes across the studies. Two researchers (T.J.G. and L.S.) independently analyzed the data, then worked together to categorize data and determine themes.

2.5.1. Data Reduction and Data Display

In the first phase of the analysis, we worked from the initial evidence table used to extract and organize the data as well as reading and rereading each study. Table 2 included each article's purpose, design or theory, collaborators, setting, methods, findings, conclusions, and significance of the work to our research questions, that is, how the findings helped to answer our question. From this table, we constructed a data reduction table, creating subcategories of the articles based on aim, design, and setting. This categorization allowed us to more closely analyze collaboration results based on the design of the work and the setting in which it was conducted.

Table 2.

Evidence table.

References	Purpose	Design/theory	Collaborators/setting	Methods	Findings/outcomes	Quality assessment/conclusions/significance
Cowan, Hartjes, and Munro (2019)	To describe the strengths of each terminal nursing degree and recommend solutions to role confusion and other challenges faced in building partnerships.	Expert Review with Exemplar Theory/Model: Lean Model	Collaborators: ICU Nurse Leadership team and UF nurse researcher; Setting: Cardiac ICU in VA facility; University of Florida, Gainesville, FA	Described challenges faced, and strengths utilized by terminally‐degreed nurses seeking to improve patient outcomes; Exemplar of QI project including ROL to support design of clinical pathway evolving into a standard of care.	Challenges: Role confusion between DNP and PhD‐focused degrees Exemplar outcomes: National benchmarks met, improved interprofessional communication, reduced ICU/hospital LOS, post‐op complications, ventilator time, mortality rates; $500,000 savings/1st 6 months.	QA: V‐B Role expectations for each terminal degree must be clear, valued for individual strengths and foci; role integration is critical; successful collaboration requires mutual respect trust, and frequent communication.
Cygan and Reed (2019)	To describe DNP/PhD collaboration within the academic setting and its impact on healthcare practice and outcomes.	Qualitative Descriptive Theory/Model: Courtney & Neiheise Model for DNP and PhD Collaboration (2011)	Collaborators: QI project 1: DNP and 1 PhD faculty; QI project 2: 1 DNP and 1 PhD student facilitated by faculty Setting: College of Nursing in Midwest, US.	Structured phone interviews conducted with collaborators to reflect on collaborative experience; project manuscripts reviewed; data from interviews and manuscripts used to describe each collaboration; member checking used for trustworthiness.	Project 1: Faculty collaborated on child obesity QI project; PhD provided grant funding; both conducted chart audit to identify problem; DNP led evidence‐based changes in clinical practice; Project 2: Facilitated by faculty, students collaborated on improving care of hospitalized prisoners; PhD student conducted descriptive study; DNP student used this data to support a QI project resulting in decreased LOS and rehospitalization.	QA: III‐B Faculty must understand complementary skill sets to collaborate; mutual trust/respect build equitable partnerships; clear expectations necessary for equal delegation of tasks. Academic institutions must value collaboration and use strategies (shared teaching, scholarly opportunities) to support collaboration.
Edwards et al. (2016)	To describe implementation of successful DNP and PhD program collaboration in an academic setting to maximize complementarity, collegiality, and shared resources.	Educational/Curricular Initiative	Collaborators: PhD and DNP faculty and students Setting: East Tennessee State University, College of Nursing	Described creation and design of new DNP program to integrate with existing PhD program; specific goals: avoid silos; capitalize on interprofessional experiences, maximize resources (human, facility, financial); promote collegiality.	Program Description: student requirements for professional development hours similar (PhD 300 h research; DNP 500 h practice); joint presentations; PhD/DNP students in group‐learning activities, joint courses (3 core and several elective); Results: Joint DNP/PhD faculty grant proposals; student retention rates increased (~90%); high student satisfaction; lower mean age of students, higher diversity.	QA: V‐A Ongoing challenges related to faculty over‐workload and shortage continue but innovation of increasing joint activities between the two terminal degrees resulted in improved PhD/DNP faculty and student collaboration and scholarly outcomes.
Graves et al. (2021)	To explore the role of the DNP in symptom‐science research and models to support PhD/DNP collaboration to strengthen translation of research to practice.	Targeted Review of the Literature	N/A	Extant literature was searched for articles describing how research and practice nursing doctorates can collaborate to improve symptom science. Examples of NINR‐SSC training models, including DNPs, were described.	Models described: Three partnership projects, within an academic setting were described; three training models developed by the NINR SSC (Symptom Science Center) included exposing DNP students and professionals to symptom science research providing opportunities to develop QI and EBP skills dedicated to symptom science endeavors.	QA: V‐A Both DNPs and PhDs contribute to symptom science, adding unique skills to advance science through research and application. PhD connection to clinical populations and DNP connections to research led by NINR can advance symptom science translation.
Jenkins et al. (2020)	To increase interprofessional doctoral education among PhD and DNP students.	Educational Initiative using Participatory Action and Qualitative Methods	Collaborators: PhD/DNP faculty and students Setting: University of Colorado College of Nursing, Aurora, CO	Educational initiative: 1st year DNP and PhD students took seminars together; asked questions related to scholarly interests and roles; Data: student and faculty focus‐groups; recorded classes, discussion boards. and student narratives. Thematic analysis used.	Key themes: (1) persistent progression toward collaboration; (2) acceleration of research‐into‐practice continuum; (3) intentional curriculum (some courses should be together, others not); (4) mutuality of leadership parameters	QA: V‐B Voice of student was incorporated into definition of scholarly roles for DNP/PhD degreed nurse; recommendations: define core and unique competencies for both degrees; clearly and consistently differentiate between PhD researcher and DNP role of implementation and translation.
Kennedy, Cameron, and Munyan (2022)	To examine the development and implementation of a research project capitalizing on the strengths of both the PhD‐prepared and DNP‐prepared nurses.	Case Analysis of Research and Practice Exemplar Theory: Courtney and Neiheise Model for DNP and PhD Collaboration	Collaborators: 1 PhD nurse researcher; 1 DNP nurse Setting: Oakland University School of Nursing, Rochester, MI	Development and implementation of research project by PhD and DNP nurse detailed highlighting strengths of both terminal degrees.	PhD nurse identified funding opportunity, was PI, and led protocol development evaluating efficacy of respiratory distress observation scale for telehealth. DNP assisted with review of literature and grant proposal, led participant training and application of technology. Both developed manuscript.	QA: V‐A Productive collaboration between terminally‐prepared nurses requires knowledge and respect for each other's strengths; ground rules and timelines must be set; frequent communication, mutual trust leads to synergy and improved outcomes.
Mauro et al. (2018)	To evaluate simulation‐based strategies for BSN students, developed through DNP/PhD faculty collaboration.	Descriptive Observational Theory: NLN Jeffries Simulation Theory	Collaborators: 2 PhD and 4 DNP faculty Sample: 570 BSN students and 57 nursing faculty Setting: 3 university campuses of a large public university, New Jersey	Faculty team developed sim‐based, unfolding case study addressing population health for BSN students; Surveys (6) created for each course‐specific activity.	Collaboration: PhDs guided research design and evaluation methods; DNPs had high simulation expertise; consensus reached on roles/responsibilities, plans for publication at start of project; had weekly group meetings, ongoing email communication. Survey results: Strong agreement by students and faculty that population health competencies were achieved and that learning experiences were engaging.	QA: III‐A/B Collaboration among PhD‐DNP faculty team resulted in simulation‐based learning strategy shown to have clinically meaningful, statistically significant effects on student learning.
Merrill et al. (2013)	To describe relationships among DNP/PhD faculty and students before and after “TRANSIT” initiatives to increase PhD‐DNP collaboration.	Descriptive Observational using Social Network Analysis	Collaborators: Nursing faculty (degrees not specified) Total Sample: 95 faculty, 77 DNP students, 35 PhD students, 13 DNSc students Setting: Columbia University School of Nursing, New York, NY	Intervention: Curricular modifications (joint seminars, workshops, professional activities) to enhance interactions among all doctoral nursing programs. Instrument: Online surveys measuring levels of collaboration ranging from “have worked with” to “don't know.”	Following the intervention, faculty collaboration increased from 23% to 32%; PhD student collaboration with each other remained high at ~70%; PhD collaboration with DNP increased by 45%; DNP student collaboration with each other increased from 10% at baseline to 34% after the intervention; DNP collaboration with PhDs increased by 19%.	QA: III‐A/B Innovations aimed at promoting interactions across nursing doctoral program students and faculty, increased collaboration over one year. Low collaboration among DNP students likely due to physical location across clinical sites and not within the school, reducing opportunity for interaction.
Nickasch et al. (2018)	Identify current perceptions of collaboration of DNP/PhD‐prepared faculty, staff, and administrators.	Mixed Methods (Survey and interviews)	Sample: 55 DNP and PhD prepared nurses; including faculty, staff, administrators Setting: 4 universities in the Midwest, US	Survey measured perceptions regarding collaboration between DNP/PhD nurses. Likert scale and open‐ended questions included. Qualitative interviews conducted either face‐to‐face or via telephone.	Quantitative: DNP and PhDs are amenable to increasing collaboration between the two and that collaboration may improve student outcomes and more success in research. Qualitative themes: (1) lack of collaboration, (2) too many barriers, (3) different by complementary skill sets, (4) multilevel confusion, and (5) shoving a square peg into a round hole. Opportunities to collaborate should be offered and encouraged.	QA: III‐A/B Terminally degreed nurses believe collaboration can improve student outcomes and research efforts but feel there are too many barriers, making it difficult to achieve. Administrators and nursing organizations should take action to break down barriers and promote collaboration.
Pinto, Dail, and Andrews (2021)	To evaluate effects of strategies to foster research and scholarship productivity among DNP and PhD‐prepared faculty.	Educational Initiative	Sample: 13 DNP faculty; 22 PhD faculty Setting: University of SC College of Nursing	Associate Dean for Research implemented three different strategies over 3 years to increase faculty scholarly productivity, facilitate promotion to next rank, increase job satisfaction, and increase collaboration between PhD and DNP faculty; (three strategies with different incentives); surveyed funded faculty at end of 3‐year project.	Strategy 1: All faculty participated in a Research Exchange program. Positive evaluations by faculty, three collaborative research proposals funded through pilot funds program; Strategy 2: two exemplars describing collaborative projects resulted in grants, presentations, and manuscripts. Strategy 3: Call for proposals resulted in seven proposals by collaborative groups, all funded. Funded faculty survey: regular meetings and clarification of role expectations most helpful; challenges included time and effort required for research; lack of research skills; poor understanding of roles.	QA: V‐A All strategies were successful in increasing productivity, however lingering issues with teaching workload not allowing time for research, especially among DNP faculty; most strategies were beneficial to both PhDs and DNPs, with DNPs benefitting the most in terms of research collaboration increase; a cultural shift is necessary to facilitate inclusivity and excitement among faculty for scholarship.
Rocafort (2020)	To develop theory about attitudes and perceptions of terminally prepared nurses regarding their roles.	Grounded Theory	Sample Phase 1: 13 nurses; 46% DNP, 54% PhD; Phase 2: 3 DNPs, 2 PhDs (Deans, Directors, or CNOs Setting: US universities/hospitals	Semistructured interviews; 1st phase interviewed 13 nurses meeting criteria; 2nd phase interviewed 5 nursing experts – to review/confirm emerging model.	Overarching social process: Following the Path; subthemes: advancing, collaboration transforming, and stewarding. “Nursing is defining itself from within.” (p. 255). Findings revealed a need or sense of responsibility to grow not just personally, but as a profession. Acceptance and need of both roles.	QA: III‐A/B Nursing profession is defining itself through the process of finding how these terminal degrees collaborate; mutual interest and respect for the perspectives of each degree is bringing much needed cohesiveness to the nursing profession.
Staffileno, Murphy, and Carlson (2017)	To identify interpersonal, organizational, and systemic determinants influencing collaboration among DNP‐PhD faculty.	Qualitative Descriptive	Sample: 25 nurses; 9 DNP; 16 PhD, most female; most between 50 and 69 years old; most Assistant Prof Setting: Large metro university, US	Four focus groups; nine questions addressed interpersonal, organizational, and systemic determinants influencing collaboration; focus groups separated by DNP or PhD degree.	Five themes: DNP not well understood; confusion surrounding research; opportunities for collaboration; lack of structural support; personal characteristics and attitudes. Much disagreement regarding the definition of research versus QI, versus translational research, versus applied research.	QA: III‐A/B Respect, clinical interest, time, desire, mutual goals were characteristics of collaboration. Organizational support for collaborative scholarship, teaching, shared governance needed.
Travers, Weis, and Merrill (2018)	To evaluate the success of a Doctoral Student Organization (DSO) in fostering collaboration between DNP and PhD nursing students.	Descriptive Observational	Sample: 86 pre‐survey (64 DNP; 22 PhD); 72 post‐survey (52 DNP, 20 PhD); Setting: Columbia University School of Nursing	Used surveys to measure collaborative relationships between DNP and PhD students before/after implementation of a DSO; Social Network Analysis used to describe relationships between students.	Significant increases in satisfaction with communication with “other degree” following start of DSO for both DNPs (p = 0.016) and PhDs (p = 0.020); network density increased by 17%; interdisciplinary ties by 39%; most had 2 new relationships; and clique membership increased by 60%.	QA: III‐A/B Recommended administrators, faculty and staff support intradisciplinary collaboration between students and faculty.
Vermeesch et al. (2018)	To develop realistic case studies to resolve ethical dilemmas in a DNP program using PhD and DNP faculty collaboration.	Descriptive Observational	Collaborators: 1 DNP faculty; 1 PhD faculty Sample: Team A: 24 DNP students surveyed; Team B: 33 DNP students; all taking Applied Ethics courses Setting: University in the Pacific Northwest, US	Initial set of students surveyed regarding their views on the usefulness of ethical case studies and framework presented; a 2nd group of students were asked to provide common experiences with ethical conflicts; data were used to construct 3 new case studies which were perceived as more realistic.	Based on PhD recommendation, DNP faculty instituted 2 student surveys (only DNP students), incorporated student feedback into next assignment. Team A: 45‐73% felt dilemmas presented did not meet objectives, were confusing, not related to DNP practice. After incorporation of feedback, Team B: 100% felt dilemmas met objectives and related to DNP practice; After student feedback through surveys, ethics case studies embedded into clinical courses.	QA: III‐A/B Ethical dilemmas are faced by nurses every day; bringing together the perspectives (clinical experiences) and strengths (research methods) of the DNP and PhD‐prepared nurses fostered development of a realistic case study by incorporating student survey responses to elicit their feedback and input.
Vincent et al. (2010)	To present an organizational framework describing how DNPs can participate in transforming US healthcare, improving patient outcomes.	Theoretical Analysis	N/A	N/A	Framework defines role of DNPs and PhDs in Knowledge Translation; PhDs perform basic research, efficacy studies (RCTs); DNPs perform implementation studies, QI, program evaluation. Together, they perform effectiveness studies. DNPs are practitioner‐researchers, must apply evidence AND evaluate findings in context to generate new knowledge applicable to a specific healthcare system.	QA: V‐B Recommendations: DNP nurses must learn skills to conduct effectiveness, implementation, and dissemination studies, including program evaluation and QI studies. The authors state these skills include scientific methods and evaluation methods.

Abbreviations: BSN, Bachelor of Science in Nursing; CNO, Chief Nursing Officer; CO, Colorado; DNP, Doctor of Nursing Practice; DSO, Doctoral Student Organization; EBP, evidence‐based practice; FA, Florida; ICU, intensive care unit; LOS, length of stay; MI, Michigan; NINR, National Institute of Nursing Research; NLN, National League for Nurses; PhD, Doctor of Philosophy; PI, Principal Investigator; Post‐op, postoperative; QA, quality assessment; QI, quality improvement; RCT, randomized controlled trial; ROL, review of the literature; SC, South Carolina; SSC, Symptom Science Center; TRANSIT, TRAining Nurse Scientists in Interdisciplinary and Translational Research in the Underserved; US, United States; VA, Veteran's Affairs.

In the second phase of the analysis, we displayed the data to allow for a more condensed view of the data (Toronto and Remington 2020) categorized by design, participants, and setting, and further focusing on the positive and negative factors associated with collaboration between PhDs and DNPs (see Table 3). This type of analysis allowed us to identify key barriers and facilitators to collaboration while also considering design and setting.

Table 3.

Review matrix for data analysis. What are the key factors (positive facilitators) and (negative barriers) associated with collaborative scholarly partnerships between PhD and DNP nurses?

References	Design	Collaborators/setting	Positive factors (facilitators to scholarly collaboration)	Negative factors (barriers to scholarly collaboration)	Identified themes
Cowan, Hartjes, and Munro (2019)	Expert Review with Exemplar	Collaborators: ICU Nurse Leadership team and UF nurse researcher; Setting: Cardiac ICU in VA facility;	Mutual understanding of role, purpose, strengths Good communication	Lack of role clarification and understanding	Mutual understanding & appreciation of strengths Strategic project planning and team building
Cygan and Reed (2019)	Qualitative Descriptive	Collaborators: QI project: DNP and PhD faculty; QI project 2: DNP and PhD students Setting: College of Nursing	Shared teaching responsibilities (leads to building a working relationship); Setting clear expectations; Understanding not only professional strengths but personal strengths, working styles, and preferences Relationship based on respect, trust, and has to be equitable	Lack of mutual understanding Lack of appreciation of strengths	Mutual understanding & appreciation of strengths Strategic project planning and team building
Edwards et al. (2016)	Educational/Curricular Initiative	Collaborators: PhD and DNP faculty and students Setting: University	Joint activities among DNP and PhD students Sharing of resources and expertise among faculty	Lack of interprofessional and collegial interactions	Strategic project planning and team building
Graves et al. (2021)	Targeted Review of the Literature	N/A	None	Poor project planning	Strategic project planning and team building
Jenkins et al. (2020)	Educational Initiative using Participatory Action and Qualitative Methods	Collaborators: PhD/DNP faculty and students Setting: University	Dependence on each discipline to advance science Curricular foci include communication, power, discipline of nursing, and EBP	None	Shared goals for the nursing profession
Kennedy, Cameron, and Munyan (2022)	Case Analysis of Research and Practice Exemplar	Collaborators: 1 PhD nurse researcher; 1 DNP nurse Setting: Oakland University School of Nursing	Acknowledge and understand strengths, differences, concerns and experience of each team member, including skills, abilities and education; Establish expectations; Value and respect each other's strengths, Discussion and agreement on ground rules/team roles/responsibilities/timelines; Frequent communication; Mutual respect, trust, and credibility	None	Mutual understanding & appreciation of strengths Strategic project planning and team building
Mauro et al. (2018)	Descriptive Observational	Collaborators: 2 PhD and 4 DNP faculty Sample: 570 BSN students and 57 nursing faculty Setting: 3 University campuses	Recognition and utilization of strengths Consensus reached on roles/responsibilities, plans for publication at start of project; Regular communication through emails and meetings	None	Mutual understanding & appreciation of strengths Clear organizational/administrative directives and guidance Strategic project planning and team building
Merrill et al. (2013)	Descriptive Observational using Social Network Analysis	Collaborators: Nursing Faculty Total Sample: 95 faculty, 77 DNP students, 35 PhD students, 13 DNSc students Setting: Columbia University	Joint activities for PhDs and DNPs (seminars, workshops)	Lack of clear organizational/administrative directives	Clear organizational/administrative directives and guidance
Nickasch et al. (2018)	Mixed Methods (Survey and interviews)	Sample: 55 DNP and PhD prepared nurses; including faculty, staff, administrators Setting: 4 universities	Clear definition of PhD and DNP roles in academic settings (tenure, scholarship, service, teaching, and practice requirements); Standards and guidelines established to determine qualifications for DNP project and dissertation project chairs and committees; Clear job descriptions, expectations, visions, and goals for collaboration; Strategic plan should include a collaborative research trajectory and reward collaboration; Establishment of collaborative work groups; Formal mentorship programs; Support for research and grant‐writing to all; Identified funding for collaborative research; Team‐teaching; Dedicated time for scholarship and clinical practice	Disagreement on eligibility for tenure; Disagreement on compensation for experience; Disagreement about acknowledging clinical practice as scholarship; Disagreement regarding equal time for research, teaching and service; Heavy teaching loads; Confusion as to role in academia.	Mutual understanding & appreciation of strengths Clear organizational/administrative directives and guidance
Pinto, Dail, and Andrews (2021)	Educational Initiative	Sample: 13 DNP faculty; 22 PhD faculty Setting: University	Research exchange; Enhanced mentoring; Pilot funds; Writing clubs	None	Mutual understanding & appreciation of strengths Shared goals for the nursing profession
Rocafort (2020)	Grounded Theory	Sample: Phase 1: 13 nurses; 46% DNP, 54% PhD; Phase 2: 3 DNPs, 2 PhDs Setting: US universities/hospitals	A need or sense of responsibility to grow as a profession, not just personally; Acceptance and need of both roles	None	Strategic project planning and team building Clear organizational/administrative directives and guidance Shared goals for the nursing profession
Staffileno, Murphy, and Carlson (2017)	Qualitative Descriptive	Sample: 9 DNP; 16 PhD, most female; most between 50–69 years old; most Assistant Prof Setting: Large metro university, US	Clear definitions for research, QI, translational research, applied research; Organizational support for collaborative scholarship; Shared governance within faculty; Mutual respect; Like clinical interests; Time allowance; Desire to conduct scholarship; Mutual goals	None	Mutual understanding & appreciation of strengths Clear organizational/administrative directives and guidance
Travers, Weis, and Merrill (2018)	Descriptive Observational	Sample: 86 pre‐survey (64 DNP; 22 PhD); 72 post‐survey (52 DNP, 20 PhD); Setting: Columbia University School of Nursing	Student organization including both DNP and PhD students	None	Strategic project planning and team building
Vermeesch et al. (2018)	Descriptive Observational	Collaborators: DNP faculty and PhD faculty Sample: DNP students Setting: University in the Pacific Northwest, US	Willingness to seek and accept advice	None	Shared goals for the nursing profession
Vincent et al. (2010)	Theoretical Analysis	N/A	Willingness to learn new skills, for example, scientific methods, and evaluation methods	Unwilling to learn new skills	Mutual understanding & appreciation of strengths

2.5.2. Data Comparison and Thematic Analysis

Once we had identified key barriers and facilitators to scholarly collaborations across the studies, we developed codes from common themes across the barriers and facilitators. We then categorized the findings based on these codes using constant comparison to develop common qualitative themes (Whittemore and Knafl ²⁰⁰⁵). Further comparison across themes allowed us to identify an overarching theme across all findings, as seen in Table 3.

3. Results

3.1. Search Results

A flow diagram (Figure 1) using the PRISMA flow diagram template describes the selection process in detail. Among 307 articles identified from the search of databases, 148 were identified as duplicates and removed. The remaining studies were screened against inclusion criteria, first by title and abstract, and then by full text, leaving 15 articles meeting all criteria to complete the final sample.

Figure 1.

Source selection flow diagram.

3.2. Characteristics of the Sample

3.2.1. Designs and Aims

Our sample of 15 articles, published between 2010 and 2022, included 12 research studies: 4 descriptive observational studies (Mauro et al. 2018; Merrill et al. ²⁰¹³; Travers, Weis, and Merrill ²⁰¹⁸; Vermeesch et al. ²⁰¹⁸), 3 qualitative studies (Cygan and Reed 2019; Rocafort ²⁰²⁰; Staffileno, Murphy, and Carlson ²⁰¹⁷), a participatory action research study (Jenkins et al. 2020), a mixed‐methods study (Nickasch et al. 2018), 2 expert reviews of the literature (Cowan, Hartjes, and Munro ²⁰¹⁹; Graves et al. ²⁰²¹), and a case analysis (Kennedy, Cameron, and Munyan ²⁰²²). We also included reports describing scholarly projects, including two educational initiatives (Edwards et al. 2016; Pinto, Dail, and Andrews ²⁰²¹). One additional paper which proposed a conceptual framework explaining PhD and DNP collaboration (Vincent et al. 2010) was also included. The articles varied in type and design but were consistent in their aim to address constructive collaborations between PhD‐ and DNP‐prepared nurses.

3.2.2. Settings and Samples

The participant samples in these articles primarily consisted of PhD and DNP nursing faculty only (Cowan, Hartjes, and Munro ²⁰¹⁹; Kennedy, Cameron, and Munyan ²⁰²²; Mauro et al. ²⁰¹⁸; Nickasch et al. ²⁰¹⁸; Pinto, Dail, and Andrews ²⁰²¹; Rocafort ²⁰²⁰; Staffileno, Murphy, and Carlson ²⁰¹⁷). Two projects (Edwards et al. 2016; Travers, Weis, and Merrill ²⁰¹⁸) included PhD and DNP students only, and four included both PhD and DNP faculty and students (Cygan and Reed 2019; Jenkins et al. ²⁰²⁰; Merrill et al. ²⁰¹³; Vermeesch et al. ²⁰¹⁸). One study (Nickasch et al. 2018), also included PhD and DNP prepared hospital staff and administrators. All projects were completed in, or in collaboration with, a university. One project was conducted in a Veteran's Administration facility (Cowan, Hartjes, and Munro ²⁰¹⁹) and another within a metro university medical center (Staffileno, Murphy, and Carlson ²⁰¹⁷).

3.2.3. Quality Appraisal

Approximately half (47%) of the studies were classified as Level V (non‐research evidence), primarily consisting of descriptions of QI or educational initiatives undertaken through PhD and DNP collaboration. The rest of the studies (53%) were categorized as Level III (qualitative, nonexperimental, mixed‐method.) All studies included clear objectives of describing collaborative efforts, and consistent and supported conclusions and recommendations. Please see Table 1 for additional strengths and weaknesses of the articles.

3.3. Synthesis of Findings

3.3.1. Overarching Theme and Subthemes

Data reduction and data display revealed several key factors across articles associated with positive collaborations (facilitators) as well as negative collaborations (barriers) (see Table 3). Key facilitators to scholarly collaborations identified included mutual understanding of roles, strengths, and purpose of each degree; clear definitions for research and EBP; effective and frequent communication; clear expectations and project goals; administrative support; mutual trust and respect; and a sense of responsibility to grow as a profession, not just personally. Factors that were found to present barriers to scholarly collaboration between PhD and DNP nurses were lack of role clarification and mutual appreciation of strengths; lack of collegial interactions; lack of clear administrative directives; poor project planning; heavy teaching loads; and disagreement regarding tenure criteria and definition of scholarship.

Constant comparison across studies, focused on key facilitators and barriers to PhD and DNP collaboration, allowed us to identify common themes. We identified one overarching theme and four subthemes that represented the characteristics of productive collaborations consistently emphasized by researchers and clinicians across these scholarly works. The overarching theme was Role Clarification, as it manifested in each of the subthemes and was discussed in these articles as either a consistent problem identified when PhD‐DNP collaborations were impeded or as a logical solution to promote improved collaborative relationships. The subthemes that further defined or categorized role clarification were:

• 1. Mutual understanding and appreciation of strengths.
• 2. Strategic project planning and team building.
• 3. Clear organizational/administrative directives and guidance.
• 4. Shared goals for the nursing profession.

3.3.2. Subtheme 1: Mutual Understanding and Appreciation of Strengths

Across all the articles, the concept of understanding and appreciating the strengths of each terminal doctoral degree in nursing was prevalent. When the practice‐focused nurse and the research‐focused nurse pause to appreciate the value of individual backgrounds, experiences, and major interests, perceptions of barriers between the two roles may lessen. This theme was emphasized in the EBP and QI projects by Cowan, Hartjes, and Munro (2019) and Cygan and Reed (2019), and the case analysis of a research study by Kennedy, Cameron, and Munyan (2022). In these projects, the authors described the planning, implementation, and outcomes of projects in which both research‐focused and practice‐focused terminally degreed nurses recognized each other's strengths and capitalized on those strengths to support their projects and improve outcomes. In the Cowan, Hartjes, and Munro (2019) project, the collaboration between the research and practice‐focused nurses resulted in improved quality of care, accomplishing national benchmarks for a major healthcare facility, and improved outcomes for open heart surgical patients. Two collaborative QI projects described by Cygan and Reed (2019) improved provider adherence to clinical guidelines, which led to cost‐effective and improved quality of care for hospitalized prisoners. Kennedy, Cameron, and Munyan (2022) presented a case analysis of a research project on which both a PhD‐prepared nurse and a DNP‐prepared nurse collaborated. They planned and implemented a research study within a hospice setting while building on each other's strengths to test the effectiveness of a respiratory distress tool used in a telehealth setting.

These authors highlighted the role of PhD‐prepared nurses in leading the review of the literature, drafting the research plan, obtaining Institutional Review Board approval, and taking the lead in grant proposal writing and dissemination of findings. The DNP‐prepared nurse was described as instrumental in assisting in the review of the literature and leading the determination of the clinical feasibility and significance of the plan for grant proposal purposes, training research assistants and data collectors, and overseeing the implementation of the intervention and collection of data in the clinical setting. Being aware of and using one another's strengths and roles to integrate both areas of expertise into a robust collaboration can increase the quality of nursing research and hasten the application of research evidence into practice.

3.3.3. Subtheme 2: Strategic Project Planning and Team Building

The second theme focused on strategic planning incorporating key steps to constructive and productive outcomes. Planning a successful collaborative project began with ensuring that each team member understood both roles (role clarification), including professional strengths, weaknesses, and expectations (Cowan, Hartjes, and Munro ²⁰¹⁹; Cygan and Reed ²⁰¹⁹). Emphasis was placed on the need for collaborators to not only understand but to respect the working styles, preferences, and personal values of each team member (Cygan and Reed 2019; Kennedy, Cameron, and Munyan ²⁰²²). Frequent and mutually beneficial communication were key components to project planning and team building because they led to mutual trust and credibility among team members (Cowan, Hartjes, and Munro ²⁰¹⁹; Cygan and Reed ²⁰¹⁹; Graves et al. ²⁰²¹; Kennedy, Cameron, and Munyan ²⁰²²; Staffileno, Murphy, and Carlson ²⁰¹⁷).

Other key strategies that led to constructive collaboration included the willingness to share resources including professional and personal expertise, access to literature or facilities, and opportunities for learning and dissemination of results (Edwards et al. 2016). There was also a readiness to seek and accept advice from all team members (Vermeesch et al. 2018). One area addressed as both a problem and a solution was institutionally enforced time allowances for scholarship activities. Through survey and qualitative interviews with both PhD‐prepared and DNP‐prepared faculty, Nickasch et al. (2018) found that lack of “allowed” or “dedicated” time for scholarly work was perceived to be more common for PhD‐prepared nurses than for DNP‐prepared nurses. DNP‐prepared nurses were more likely to be assigned time for clinical hours and teaching in place of scholarly work (Pinto, Dail, and Andrews ²⁰²¹). Dedicated time allotted equally to both practice and research‐focused nurses to accomplish mutual goals (Staffileno, Murphy, and Carlson ²⁰¹⁷) was a key strategy for planning successful collaborative projects.

3.3.4. Subtheme 3: Clear Organizational/Administrative Directives and Guidance

Several of the authors' findings and recommendations supported clearer organizational, and administrative guidance and direction to improve collaborations between terminally degreed nurses. The focus of these recommendations was grounded in the need for administrative support in the articulation of distinct roles for the PhD and DNP nurse faculty within the academic setting (Nickasch et al. 2018). Unclear, inconsistent organizational requirements among schools and colleges of nursing regarding tenure, scholarship, service, teaching, and practice requirements for the two nursing roles complicated and presented barriers to scholarly collaboration (Nickasch et al. 2018; Pinto, Dail, and Andrews ²⁰²¹; Staffileno, Murphy, and Carlson ²⁰¹⁷). Nickasch et al. (2018) presented both qualitative and quantitative findings from DNP and PhD‐prepared faculty supporting that organizational standards and guidelines should establish clear qualifications for DNP project and PhD dissertation chairs and committees. These organizational clarifications help dissolve barriers and promote collaboration further by clarifying job descriptions, clinical and teaching expectations, visions for scholarship, and service goals for each role (Nickasch et al. 2018; Staffileno, Murphy, and Carlson ²⁰¹⁷).

The need for formal mentoring programs and grantsmanship for both research‐focused and practice‐focused faculty were emphasized in the findings and recommendations of multiple projects (Nickasch et al. 2018; Pinto, Dail, and Andrews ²⁰²¹; Staffileno, Murphy, and Carlson ²⁰¹⁷). Following a successful strategy within their university to increase scholarship productivity among PhD and DNP‐prepared nurses, Pinto, Dail, and Andrews (2021) suggested that organizations should offer pilot project funds and maintain active writing clubs for faculty members. In addition, the strategic plan of the organization should include a collaborative research trajectory and collaboration rewards, as well as dedicated time for scholarship and clinical practice to be appropriately distributed for both degree foci (Nickasch et al. 2018). Staffileno, Murphy, and Carlson (2017) shared qualitative findings supporting that shared governance among faculty promotes PhD‐DNP scholarly collaborations. Jenkins et al. (2020) also supported shared governance in their participatory action research which found both concentrations (PhD and DNP) need to agree upon leadership responsibilities during collaborative activities.

Administrators and organizational leaders are responsible for the delegation of teaching assignments among faculty. According to Cygan and Reed (2019), who described a QI project conducted collaboratively between PhD and DNP faculty members, shared teaching responsibilities lead to the development of improved working relationships among faculty. This finding was supported by Nickasch et al.'s (2018) qualitative findings indicating opportunities for team teaching between both types of nurse faculty encourage scholarly collaboration. Likewise, joint activities among PhD and DNP students in the classroom (Edwards et al. 2016; Merrill et al. ²⁰¹³) and in student organizations (Travers, Weis, and Merrill ²⁰¹⁸) were reported to lead to greater satisfaction in communication, increased networking, and stronger interdisciplinary ties. The importance of supporting collaboration between PhD and DNP students who will be nursing faculty and professional terminally degreed nurses cannot be overstated.

3.3.5. Subtheme 4: Shared Goals for the Nursing Profession

Although this theme of shared goals and vision for the nursing profession was not overtly mentioned in all articles, it was implied as an underlying requirement for constructive, collaborative work between the two nursing roles. Rocafort (2020) conducted a grounded theory study to develop a theory surrounding the role perceptions of terminally prepared nurses. Rocafort (2020) interviewed 13 nurses for this study, 46% were DNP‐prepared, 54% PhD prepared, and when combined, 54% had greater than 30 years of nursing experience. Findings from this study revealed these nurses felt a sense of responsibility as a profession to accept both roles; one to conduct research and discover new findings and one to translate the findings at the bedside for patient‐centered care. Both terminally degreed nursing professionals are expected to support the growth of nursing as a profession.

Also presented as key to productive collaborations between PhD‐ and DNP‐prepared nurses was the need for the nursing profession to clearly define, within the discipline, the qualifications for work to be represented as research, evidence‐based QI, translational research, and applied research. These terms are often used interchangeably, which can cause confusion and disagreement and may impede scholarly collaborations between nurses with varied educational preparation (Staffileno, Murphy, and Carlson ²⁰¹⁷). Vincent et al. (2010), who proposed a translational framework to further define the roles of PhD and DNP nurses, suggested that DNP curricula should include more intensive content related to the conduct of effectiveness, implementation, and program evaluation studies. The inclusion of additional content and practice of research skills for the DNP, as well as additional content and practice of QI and translational research for PhD students, could lead to increased seamless collaboration between DNP and PhD graduates. All authors highlighted the need for mutual respect for the educational preparation and purpose of each of these concentrations. It is through these actions that we will continue to define and grow nursing science and the profession of nursing.

4. Discussion

This integrative review identified 15 articles published between 2010 and 2022 that described or studied scholarly collaborations between PhD‐ and DNP‐prepared nurses. We found across studies that scholarly collaborations were best defined as evidence‐based projects completed by a team of PhD‐ and DNP‐prepared nurses who utilized their strengths to generate or apply research evidence to improve healthcare outcomes or nursing education. Our results indicated low‐level research evidence, but high‐quality work described these collaborative efforts and their outcomes. These articles provided qualitative and anecdotal evidence of the characteristics of PhD‐DNP collaboration efforts in research, QI, EBP, and other types of scholarly projects. Below, we discuss the key factors associated with these efforts as described in our sample.

Across these articles, we identified several factors consistently described as positively supporting scholarly collaboration between these professionals as well as several barriers to their collaborative efforts. When studying these characteristics across articles, we identified an overarching theme of Role Clarification highlighted the need to clarify differences in educational preparation, purpose, and strengths of each of these doctoral degrees. Four supporting subthemes further described the key factors associated with positive collaborations among PhD and DNP nurses: (1) Mutual understanding and appreciation of strengths; (2) Strategic project planning and team building; (3) Clear organizational/administrative directives and guidance; and (4) Shared goals for the nursing profession. Further, we detected a consistent appeal from these authors for mutual respect among all doctoral‐prepared nurses so that meaningful collaborations may occur.

The overarching theme of the need for role clarification between the DNP and the PhD across these studies is not a new finding. Confusion regarding the DNP degree has been discussed in the literature for many years (Chism 2009; Udlis and Mancuso ²⁰¹⁵). Differentiation between the degrees and definition of the role of the DNP nurse in practice was critical to ending this ambiguity (American Association of Colleges of Nursing ²⁰¹⁴). Most recently, a study conducted by the American Association of Colleges of Nursing (2022b) described the utilization and outcomes of the DNP nurse, concluding that there remains confusion among stakeholders as to the purpose and goals of the DNP degree. Similarly, as described earlier in findings from Orton et al. (2019), clinical employers in Sweden, and in other countries, lacked knowledge of the strengths PhDs bring to the clinical setting to identify problems, test interventions, and provide evidence‐based solutions. These consistent findings of lack of knowledge of the educational preparation, purpose, and value of these differently prepared nurse scholars illuminate the need for scholarly collaborations among PhD and DNP nurses. These scholarly collaborations have the potential to help clarify these roles to employers and to the public through the dissemination of research and EBP findings by these DNP‐PhD nurse teams.

One of the recommendations by the AACN in their recent study of the DNP (American Association of Colleges of Nursing ^2022a) was to determine the appropriate metrics to measure DNP outcomes and to conduct research to describe the impact of the DNP in the practice setting. These tasks can be accomplished through collaboration between nurse researchers, PhD nurses, and nursing practice professionals, DNP nurses. Findings from these studies would educate employers and the public regarding the role and value of the DNP and support the vital need for collaboration between DNPs and PhDs to advance the science and practice of nursing.

The supporting themes in our findings provide a foundation to better understand the initiatives and assistance needed by academic institutions, clinical employers, and the nursing profession to support the scholarly endeavors of these nurses. Emphasis on the different educational preparation of these nurses that explains why their strengths are different but complementary is needed in the classroom, the healthcare setting, and in the education of the public. Financial and general resource support from administrative bodies in both health care and academic settings is needed to assist and incentivize team‐building and joint project planning. These joint efforts should focus on problem identification and evidence‐based solutions to improve the quality of care and processes of care – with emphasis on the critical roles of the DNP and PhD nurses to accomplish these tasks. An example of this type of support is evident in the efforts of the Southern Nursing Research Society (SNRS), a prominent, regional nursing organization in the United States which provides grants specifically for projects conducted through a DNP/PhD team collaboration.

Additional findings from this review indicated some confusion among the authors of these articles and among participants regarding the terms research, quality improvement, evidence‐based practice, translational research, and applied research. Clarification of these terms in both PhD and DNP academic programs could help reduce confusion in academic and professional settings. Understanding the different nursing roles, strengths, and expectations of each degree may accelerate the process of productive scholarly collaboration, which in turn may result in outcomes of improved quality of care and more efficient healthcare systems.

4.1. Limitations

Limitations among the studies included small sample sizes and lower‐level evidence primarily via descriptive surveys or qualitative interviews, case studies, or QI reports. We did not detect significant flaws in the articles but recognize that among projects within the lower levels of evidence, quality may vary. Another limitation was that all the articles in the sample were conducted in the United States. Articles identified internationally did not address scholarly collaborations between doctorally prepared nurses but were focused on the barriers faced by doctorally prepared nurses in the clinical setting. Future research should include populations of nurses outside the United States to describe scholarly collaborations more globally.

4.2. Conclusion

This integrative review synthesized the published literature defining and describing the key characteristics of scholarly collaborations between doctorally prepared nurses. Findings indicated limited high‐quality evidence that underpins how nursing professionals should collaborate, and the type of support needed to increase the quantity and quality of collaborative scholarly efforts. Through one overarching theme and four subthemes, we found that PhD and DNP role clarifications are critically needed. We believe that collaborative efforts by PhD‐ and DNP‐prepared nurses will contribute to communicating role differences and quantifying the value of each of these degrees. Future research could include a unifying model of collaboration that would change how we relate, study, and practice within the nursing profession.

This integrative review contributes to the evidence supporting successful collaborative projects between PhD and DNP‐prepared nurses and illuminates the overall respect nursing professionals have for the gifts and talents that all bring to the table for the purpose of caring for others. This review offers evidence and recommendations to all nurses, particularly nursing leaders in practice and academia, to help increase scholarly collaborations and partnerships among nurses to continue to advance nursing science and practice.

Author Contributions

All authors contributed to this work. Theresa J. Garcia contributed to the conception of the paper, data extraction, analysis, and interpretation of the data, drafting, critical review, revision, and final approval of the manuscript. Rebecca S. Koszalinski led the conception of the paper and contributed to data collection, data extraction, draft, review, and final approval. Jinbing Bai contributed to the conception of the paper, data collection, draft review, and final approval. Lenora Smith contributed to the conception, data extraction, interpretation of the data, and final approval. Natalie Shen contributed to the conception, data collection, and final approval.

Conflicts of Interest

The authors declare no conflicts of interest.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.